Lost children: A force for change

Four-part series Day Four Children mingled with sex offenders in the smoky TV lounge of Idaho’s largest psychiatric hospital. Charlie Johnson was outraged. How could this be? “It was like something out of Dickens,” he said. That was 1979, and Johnson was just out of law school. Idaho Legal Aid had hired him to look for trouble at the state’s mental hospitals. Trouble found him. In the dingy lounge of State Hospital South in Blackfoot, a handsome, heavy-set teenager grabbed Johnson’s sleeve. I’ve been here three years, Jeff Davis said. I want out. I want to go home. Jeff and 16 other children on the ward slept in 20-bed rooms among adult child molesters. The kids whispered of abuse. Jeff said he was shackled in leather restraints for 24 hours at a time, zoned out on big doses of Thorazine. There was no school in the hospital. Johnson’s outrage grew as he heard the rest of Jeff’s story of abandonment, abuse and mental illness. Idaho’s response to Jeff’s problems was forced separation from his mother and indefinite incarceration at Blackfoot. There were no community clinics. Soon Johnson and another attorney, Howard Beladoff, were pounding out a federal class-action lawsuit intended to force Idaho into the modern age of psychiatry. The woeful tale of Jeff, then 17, was the first to be told in the complaint, which came to be known as the Jeff D. lawsuit. Johnson hoped for a quick resolution. But 22 years later, the Jeff D. lawsuit still churns through federal court. It has outlasted four governors and four federal judges. It fills a dozen volumes in federal court and 27 boxes in Jeff’s lawyers’ offices. It’s one of the oldest lawsuits of its kind in the nation. Johnson and Beladoff have remained on the case throughout, aging from young rabble-rousers to fathers who soon will qualify for AARP. Jeff, now 38, has been a shadow at society’s margins for two decades. He’s lived like a hobo, wandering from Spokane to Salt Lake City, homeless and jobless, learning to enjoy eating out of Dumpsters. When his depression grew too thick, he got himself committed to psychiatric hospitals. He is a most unlikely hero for mentally ill children in Idaho. But for two decades his lawsuit has forced gradual improvements in children’s mental health care. “Jeff D.” has become code for a child needing help. In the past two years, as his chaotic life began to stabilize, Jeff has finally taken an interest in his own lawsuit. Today, looking like a bloated Elvis with muttonchops and a sly grin, his greatest concerns are getting new dentures, money for bowling and the latest news on the Spokane Chiefs hockey team. He sometimes wanders the streets of Boise, looking for the mother who twice abandoned him. Becoming a `cave man’ Jeff was a Valentine’s Day baby, born in 1964 to Jim Davis, a laborer from Texas, and Karen, an Oregon farm girl and a patient of Idaho’s mental health system. Ten months later, police in Portland found Jeff and his 2-year-old sister, Delania, abandoned in a seedy downtown apartment. Because Jeff’s ailing grandmother lived in south Seattle, Washington’s Department of Public Assistance took custody. An abusive foster family took in the children. On a berry-picking foray in autumn 1966, the couple, Miles and Ruby Parmenter, were seen by other pickers choking Delania, beating her with wooden stakes and covering her mouth to stifle screams. The child arrived dead at Auburn General Hospital, with a fractured skull and more than 150 bruises. Jeff, then 2, had bruises on his arms, back, chest and legs. He had watched his foster parents beat her to death. “I loved Delania,” Jeff said in an interview last winter in Boise. When he talks about his sister, he cocks his head and avoids eye contact. Without teeth, he lisps. “Someone didn’t, though.” The Parmenters were convicted of manslaughter and given what the judge felt was a “reasonably severe” sentence of one year each. It was a headline-grabbing case that launched a review of all foster homes. Karen Davis briefly reappeared, to file a wrongful death suit that was quickly dismissed. The trauma, a psychologist wrote after seeing Jeff at age 8, caused “perhaps irrevocable psychological and organic developmental defects.” It’s unclear if Jeff inherited a tendency toward the depression he now suffers, or if it’s caused by the abuse. Jeff tumbled from one foster home to another. He was to be adopted in one home, until he attacked a newborn. He was beaten at another home and fled. He ran away five times from the Ryther Child Center, a Seattle foster center for mentally ill children. There was no room for Jeff at Washington’s mental hospital for kids. Child psychiatry was slowly evolving, and few of the drugs commonly used now were available then. Little was known about inherited mental illness, so psychiatrists relied on therapy such as regression. That technique was suggested for Jeff - treating him as an infant, giving him a bottle and starting over with parenting - but he was already too angry and defiant at age 8. Asked what he’d be doing at age 30, Jeff accurately predicted he’d be living on the streets. Another technique was to toss mentally ill children in jail, even if they hadn’t committed a crime. Jeff spent nearly two years at Echo Glen Children’s Center, until the Legislature outlawed the practice of housing mentally ill kids in jail in the late 1970s. Jeff’s case then landed on the desk of juvenile probation officer Jan Esterly. Most foster homes refused kids who keep running away, and the one that accepted them was too expensive for the state’s taste, Esterly said. Jeff was “so detached,” said Esterly, now retired. “You’d ask him a question, and he’d curl up in his chair and not answer.” Esterly temporarily placed Jeff in the Antonian School in Cheney, a now closed boarding home for troubled kids. His good behavior was rewarded with sports magazines - but that didn’t happen often. The school constructed a special padded room for him. The Antonian’s director described Jeff, then a teenager, as a “cave man” who hit girls he was attracted to and stashed food under his bed. Then Esterly found an unconventional solution. Through Jeff’s ailing grandmother, Esterly located Karen Davis, the birth mother who had abandoned him 13 years before. The three of them piled into Karen’s dilapidated car one Friday in autumn 1978 and drove back to her home on Boise’s River Street. “It was a long and quiet trip,” Esterly said. “I remember thinking, `I don’t even know this woman.’ I started to question my judgment. I wouldn’t do that today.” The reunion lasted a weekend. Jeff remembers running away when his stepfather whipped him with a belt. That Monday, Karen Davis called the social worker who was helping her with her own mental health problems and asked for relief. At the time, there were no outpatient treatment clinics for such kids, a key point in the Jeff D. lawsuit. The state’s solution was to have Davis again relinquish custody. Jeff was sent to State Hospital South in Blackfoot, where other “incorrigible” children were held. He would stay there for most of the next four years. Of the brief family reunion, Jeff said wistfully, “She probably did what she had to do.” A victory, then delay For Johnson and fellow Legal Aid attorney Beladoff, the Jeff D. lawsuit started with a bang. They found three other children like Jeff, and their suit was granted class-action status within a year, covering more than 2,000 mentally ill kids under 21 held outside their homes. State attorneys defended the practice of mixing adults and kids at Blackfoot, noting it was common nationwide. Then Jeff’s attorneys found records of dozens of physical and sexual assaults by adults against kids at Blackfoot; a year after the lawsuit was filed in 1980, the American Psychiatric Association condemned the practice. Johnson is the more volatile of the two lawyers, a thrill-seeker who loves flying his sailboard off waves at the Columbia Gorge. “I haven’t assaulted anyone yet on this case,” he said proudly. “I’ve been real calm most of the time.” Beladoff is the tactician. He enjoys sneaking into legislative briefings on the Jeff D. case, smiling as lawmakers wonder if they’ve fixed things enough to satisfy him. As the 1983 trial date neared, the U.S. Supreme Court ruled in the landmark Penhurst case that the constitutional right of due process required patients in mental hospitals to be discharged to community care if possible. It helped propel the de-institutionalization movement that has closed mental hospitals nationwide. The state settled the case in June 1983, agreeing to help kids avoid a stay at Blackfoot by setting up a network of specialized foster homes and community treatment centers. It quickly built a new separate ward for kids, near Blackfoot. “I thought that was it,” said Beladoff. “I thought it might take some time to set it all up.” It has. After 22 years, the network still is not fully established. Down and out The lawsuit was already settled when Idaho social workers dropped 19-year-old Jeff off at a motel room near the hospital. Social workers felt it was time for him to enter adulthood. It was like dropping him on another planet. He’d been outside the hospital just a few times in four years. This time, Jeff threw a tub of peanut butter through a motel window and got kicked out. His years in institutions failed to teach him how to make friends, cook, handle money or control his anger. Outbursts and poor hygiene got him fired from his first job at a Boise manufacturing plant. He spent the next 16 years as a transient, using disability checks to hop buses to Utah, Oregon, Montana or Spokane, trying to keep his depression at bay. During a half-dozen admissions to state hospitals in Idaho and Eastern State Hospital in Medical Lake, psychiatrists offered diverse theories about his mental illness. Some doctors saw Jeff as merely angry and capable of faking illness for regular meals and a chance to feed the ducks at Idaho’s State Hospital North in Orofino. Less cynical evaluations suggest he has severe bipolar disorder, a personality disorder akin to schizophrenia, anxiety and post-traumatic stress disorder, from his childhood. Jeff grew to so distrust psychiatrists that he refused to see any after about 1995. In the mid-1980s, Jeff decided he needed a change of scenery and moved from the streets of Boise to Spokane. He found the Carlyle Hotel, a cheap downtown apartment building once so full of the mentally ill that it was known as Eastern State Hospital’s eastern ward. In the hotel’s owner, Ed Hoffman, Jeff found a surrogate father. Jeff trusted him enough to have Hoffman pay his bills. The two talked baseball, about which Jeff retains an extraordinary memory. When his depression struck, Jeff would stop showering, start eating out of Dumpsters again. His hair, beard and fingernails would grow long, and he would swell to 300 pounds. When the depression lifted, Jeff would get a haircut and catch a Spokane Indians game. He’d sometimes get antsy and hop a bus, Hoffman said. Unbeknownst to Hoffman, Jeff’s destination was often Boise, where he’d roam the streets looking for his mother. Then he’d call Hoffman for a ticket back. “Jeff was like a kid, looking for a parent to push against,” said Hoffman. “We became his parents.” The odd friendship ended in 1992, when Jeff trashed his room and smeared feces on a wall. He was evicted. Hoping for five more years While Jeff floundered, his legal case became legend in Idaho’s mental health community. Although Idaho built a separate ward for children in the 1980s, the system of outpatient care it promised in 1983 wasn’t materializing. Experts testified throughout the 1990s that parents were being forced to relinquish custody in order to get treatment, just as Karen Davis had in 1978. The state also was criticized for failing to appropriate the money it promised. A pattern formed: The state would agree to fix things, but didn’t follow through, until Johnson and Beladoff went back to court. Each time a federal judge considered a contempt order against a new governor, the state would settle again, promising even more care for mentally ill children. Idaho has settled the Jeff D. lawsuit three times, and violated its agreements twice by failing to make improvements. In the early 1990s, Dr. Jack Riggs grew frustrated by seeing mentally ill children suffering a psychotic breakdown rushed into Coeur d’Alene emergency rooms where he worked. “If you have a broken arm or appendicitis, it’s pretty easy to know how the treatment goes,” he said. “For mental health, whether it be children or adults, it was always so much more difficult. It was always so hard to figure out what services were available.” Riggs was elected to the Idaho Senate in 1996, and became lieutenant governor last year. The reasons for inadequate care for mentally ill kids became clearer to him. “If the legislators don’t know what the system is, they’re reluctant to fund it,” he said. “The Legislature wants things that are organized and make sense. If they get reports of success, there’s a higher likelihood of its continued funding.” Boise parent-advocate Claire Kiener, whose son has bipolar disorder, said the Jeff D. lawsuit is “the best thing that’s ever happened for mentally ill children in Idaho.” It’s only because of federal oversight of the lawsuit that any improvements are being made, she said. “I hope the Jeff D. lawsuit goes on for five more years,” she said. “Institutional change takes a lot of time, and we’ve still got a long way to go.” Jeff called Charlie Johnson once in the 1990s, to see if he could get money from the lawsuit bearing his name. But the attorneys never asked for damages, reasoning that they “didn’t want to bankrupt the state,” said Beladoff. `The court grows weary’ Jeff at last found a mother figure in his life in 1997, when Stacey Butler, an Idaho caseworker, got a call from Boise’s homeless shelter: You’ve got a new client, and he needs a bath. Butler was then buying a social service organization that had a state contract to help mentally ill adults. The contract, for “psycho-social rehabilitation,” was among the small improvements the Jeff D. lawsuit had produced. Within a year, she realized her new client was Jeff D., and that his lawsuit helped pay her wages. Their relationship was rocky at first. Butler, now 32, is a no-nonsense hipster with funky glasses and thick shoes. Although she quickly got Jeff a subsidized apartment, he refused to answer the door. She returned daily, pounding harder, until Jeff relented. The two bonded, over cigarettes, by talking about his background. She got many of his psychiatric records, helping him piece together a childhood blurred by trauma. She reluctantly tried to help Jeff find his mother. The search failed. One day in September 2000, Butler saw a newspaper story: A federal judge had issued a blistering critique of Idaho’s handling of the Jeff D. suit. “The court grows weary,” wrote U.S. District Court Judge Lyn Winmill. “Year after year, the plaintiffs demonstrate that the state has not fulfilled its promises or respected this court’s order. Year after year, this court has entered decrees giving the state more time to provide the care promised to a class of its neediest citizens.” Winmill told Gov. Dirk Kempthorne - now the fourth governor wrapped into the suit - that his staff had 60 days to do as it said it would in 1983. His tongue-lashing started the most serious reforms in two decades, with added legislative funding and formation of a better statewide system. Butler read the story of Winmill’s ruling to Jeff. How about a trip to court? she asked him. Longing for family Jeff D. walked into the Pocatello branch of Idaho’s federal court last year in new jeans and a black suede vest bought for $14 at Burlington Coat Factory the day before. He hadn’t seen Charlie Johnson in more than 20 years, but recognized him immediately. Jeff tried to read a brief statement he wrote during the trip from Boise. He broke down, and handed the card to Beladoff. He broke down, too. Finally, Johnson read Jeff’s scrawl to the court. “My name is Jeffrey Lee Davis. I wish when I was a kid the state had services like I get now as an adult. … I might have been able to stay with my mom. The state should put more money into children and juvenile programs so they don’t end up like me.” Many people associated with the case, including the state’s attorney, thought Jeff D. was dead. “People think about a 14-year-old trapped in a hospital, and here Jeff walks in, a man,” said Butler. With Jeff sitting in the gallery, state attorneys detailed the most significant progress toward resolving the lawsuit in two decades. Within months of Winmill’s screed, Riggs had been appointed to lead the newly formed Idaho Children’s Mental Health Council. Legislators had suddenly dumped an additional $7 million into children’s mental health, more than all the new funding in the past decade. Lawmakers authorized hiring 25 new staffers, although 10 of those positions are still unfilled because of a state hiring freeze. In Kootenai County, extra staff and more aggressive billing for the state-federal Medicaid program has ballooned the number of children’s mental health providers from two to 20, and the number of state-funded cases from 20 to 200 over the past three years. “The Jeff D. lawsuit - with the judge saying, `You’ve got to do this’ - has put the spotlight on children’s mental health services,” said Kateri Piccard, the state’s head of social work in Coeur d’Alene. “The program went from infant to toddler really quick.” Legislators knew what they were funding: a detailed, 48-point plan written largely by Beladoff that stole the most progressive elements of children’s mental health systems across the country. The heart of the plan, now being implemented, is creation of children’s mental health councils in each county seat to help parents get appropriate care for their kids quickly. Decker Sanders, a retired Air Force master sergeant hired to set up the councils, hopes to work himself out of a job by the end of the year. “This thing’s been dragging on for 23 years,” he said last winter. “There’s a lot of apprehension, rightly so, about whether this department and this state are committed to this care. All the rhetoric in the world and all the good intentions won’t help. We need to start walking the talk.” Jeff now lives in a subsidized apartment in Boise, across the street from a hospital psychiatric ward he once visited regularly. He refuses psychiatric care, and flushes his anti-depressant medications. He would likely starve without public assistance. Butler worries about what will happen to him in April. Jeff made such progress that he may no longer qualify for Butler’s case management and mothering. Last winter, while slumping through a week of depression, Jeff had eaten his two-week supply of food. He mentioned eating out of a Dumpster. Butler said they’d go to the grocery store the next day. Jeff prepared by clipping his nails, washing his hair and putting on a clean purple fleece shirt, size XXXL. Jeff now showers regularly, partly to please Butler. He had all his rotting teeth extracted a few years ago, and recently tossed his dentures down the toilet. Soft foods - sloppy joe mix, clam chowder, Jell-O - went into the grocery cart. He loves all things peach, so peach pudding and peach shampoo went in as well. Wheeling down an aisle, Jeff saw a little girl who reminded him of his sister, Delania. He flashed his gums in a wide grin. The girl’s mother hustled the toddler away. Jeff and Butler shopped carefully, tossing out expensive bacon for a cheaper brand. Jeff tries to save money from his $596 monthly disability check until he has $400. Then he hops a bus, and is gone for a week. He also saves money for bowling. Every Friday morning, he meets a group from the Micron employees’ association at an east Boise bowling alley. He bowls a 160 average. When he feels flush, he buys an out-of-town paper to read up on Spokane sports. For Jeff, this is a full and stable life. Still, he sometimes takes a bus to downtown Boise and drops by his mom’s old house on River Street. “Having no family, it’s a bummer,” Jeff said, fingering an inch-wide Velcro strap on his right wrist that hides the scar of a suicide attempt. “If I had a family, I wouldn’t have gotten in all this trouble.” UNPUBLISHED CORRECTION: Funding for this series was provided by the Foundation for Child Development, through a six-month University of Maryland journalism fellowship for staff writer Jonathan Martin. The name of the sponsoring organization was incorrect in this story.